The Team Builder: Lucia Gonzales

Sim Man lies quietly in his hospital bed, his wires disconnected, lungs at rest and speech silenced. He won’t be needed today. His hangout, however — Barcelona, Room 100 — is humming quite nicely with the business of nursing.

“Okay, now the ones with the pillows are the patients who just had their gall bladder out,” says Associate Professor Lucia Gonzales, looking over her partnered students in the midst of this lesson on patient comfort and perioperative nursing. “What are some of the nursing diagnoses your patient may have?”

Just two months into the Master’s Entry Program in Nursing, this cohort of 16 students not only looks the part with their identical blue scrubs and arctic white shoes, but they live the part. “Acute pain,” calls out one. “Impaired mobility,” says another. “Risk for infection,” adds a third.

Clearly at home in USD’s Simulation and Standardized Patient Nursing Laboratory, the students come to the program with undergraduate degrees as varied as art, political science and biology, and all share a desire not only to become nurses, but to serve in leadership positions. It’s up to Gonzales and her skills lab teaching partners — Jackie Close and Raelene Brooks — to provide a solid foundation in nursing practice and skills, and in the master’s-level training they need to learn to become leaders.

“You are going to teach your patient deep breathing and how to cough,” Gonzales continues, reminding them that the exercises help to prevent pneumonia after surgery. “What are you doing with all those alveoli in the base of your lungs?”

“Filling them up,” the students answer quickly.

“Great, now have your patient breathe in through their nose and out through pursed lips,” she says, standing tall before the semicircle of students and demonstrating perfect technique. “Practice once before you teach. Inhale, then hold, two, three. Out.”

With more than 40 years as a nurse, administrator and educator — and 20 years as a motivational speaker — Gonzales draws out students’ strengths through her active learning sessions. “For me to be happy, the students have to be engaged,” she says.

Paired off with their pillows, the nursing students trade instructions and pursed lips, then press against imaginary incisions as their partner coaches them to cough, cough, cough in threes to temper the velocity and reduce the risk of tearing sutures. Gonzales and Close wind through the students, listening and guiding, and they take turns leading the lesson, modeling one of the most important skills these students will need to master.

“We want to show solidarity, that we get along very well and that we share,” Gonzales says, pointing out that much of the student training incorporates problem-based learning in groups. “When they work on the nursing floor, very few nurses work in an isolated situation. I want to make sure they can work in group settings with different individuals.”

Gonzales also opens her research to student participation so they can develop the skills to stay on the cutting edge of best practices throughout their careers. It’s not enough to just read about research, she says. “If they can say, ‘I’ve performed research, I’ve recruited, I’ve analyzed the data and I’ve made posters to disseminate the results,’ they are very valuable. That’s a motivated nurse who is already plugged into the fact that he or she needs to know the latest, state-of-the-art care.”

This philosophy dovetails nicely with the nursing lab itself, the cornerstone of skills training. In this detailed replica of a clinical setting, hospital beds line the room, occupied with mannequins and simulators as sophisticated as Sim Man and his frequent companion, Noelle, which star in intricate computer-aided scenarios such as coding and giving birth. Even better, in keeping with best practices, USD is one of only two nursing schools in the area to incorporate standardized patients — specially trained actors — for much more realistic simulations.

The result? Nursing graduates whose training takes them beyond the complex skills of nursing to embody the art of healing. The journey begins with each professor, such as Gonzales.

“We have to be good nurses to our students, demonstrating caring, concern and respect,” says Gonzales, who belonged to both Future Teachers and Future Nurses of America in high school. “It’s not just a job for us. We are passionate about nursing and passionate about teaching. It’s the best faculty you can have.” — Trisha J. Ratledge